A year ago I wrote a candid response to the registration crisis midwives were facing as the national registration of health professionals legislation made the rounds of each State. I am sad to say that some of the somewhat satirical comments I made have now started to eventuate. This should be shocking and horrifying to anyone who values the principles of autonomy and self-determination. You now no longer have the ultimate say in what happens to your body if you choose care by a registered health professional. Your choices may be vetoed by a medical gatekeeper. Women, it seems, have less right to self-determination in birth than horses.

Women who want to home birth are now worse off than ever before. There have been recent reports in the media about women being refused prescriptions for syntocinon by midwife-wary GPs. The witch hunt is in full swing with midwives being reported left, right and centre and soon the term ‘midwife’ will only openly be used in the halls of power, where midwifery staff can be controlled and where women’s rights to self determination are vastly eroded. Pretty soon the tales about home born babies will be hushed up and a cone of silence will encase those who dare to choose this option. Women will have to join secret birthing societies in order to get the information they need to hire an underground midwife to support them so they can have, what they consider to be, a safe birth and they won’t be able to refer to these birth helpers as midwives. Doing so could mean prosecution, so instead they’ll say they were birthing unassisted with partners and “friends”. Midwives will be unable to accompany women to hospital should they need to transfer and adequate consultation with medical professionals will become impossible. Yes, the situation is dire indeed.

In the wake of all of this, I have chosen to not to have another baby. It is clear to me that none of my choices will be respected in the system. I wouldn’t be “allowed” to even use water for pain relief because of my two previous caesareans (even though I birthed my last baby naturally). I also don’t feel comfortable putting a midwife in the position of supporting me when each previous pregnancy involved complications that put me in the “high risk” category, despite the normalcy of my pregnancies in reality. I feel like my only choice is to birth unassisted at home but I’m not willing to do that either. So, that’s, that. No more babies for me.

I am extremely angry that my personal life and our family choices have been interfered with by the state to such an extent, that I no longer feel that Australia is a democracy in the true sense of the word. When a government can dictate to you that you cannot choose for a normal bodily function to happen in the comfort and safety of your own home, then that is not freedom or self determination.

The thing I find really disturbing is that there are a plethora of so-called experts who support what the government is doing and who think it is okay to deprive women of their liberty. Some have even called for homebirth to be made illegal. Excuse me? Following that reasoning, we should also make patient-choice caesareans illegal and patient-choice inductions illegal. Not that I want to compare homebirth to medical procedures but you get my drift. If they are going to control once choice, why not control them all!

So what do we do now? I have no doubt it is going to be a rough road ahead for both women and midwives who are passionate about choice in childbirth but we need to keep telling our stories, the good stories about birth. If our stories die, so will home birth.

My VBAC story

A picture tells a thousand words. For the complete story of my kids’ births visit my website: www.casmccullough.com/stories.shtml.

That the majority of people are too busy to understand the complexities and evidence behind the choice to birth a baby at home doesn’t surprise me. But it never ceases to astound me how quick people are to judge women who make this choice or who, indeed, feel they have no choice. Why do people believe what some pubescent journalist fresh out of uni says when nine times out of ten the information is at best superficial, at worst down right lies? And they certainly don’t improve their reporting accuracy as they get older…

Take the case of an opinion piece in the Daily Telegraph today http://www.news.com.au/dailytelegraph/story/0,22049,25298631-5001030,00.html.

The journalist, Fiona Connolly, claims “Home births are selfish, irresponsible, anti-reason and anti-progress.” She also has the audacity to compare birth in a poverty-stricken, war-torn Somali village with homebirth in the safe, leafy suburbs of Australia. Connolly fails to consider that women who homebirth in Australia DO have access to all the modern technology and a trained professional to assist them. Somali women in remote villages do not. I’m not really sure where the reason comes in to this argument.

What strikes me about this ill-informed piece was what was missing. What about the perinatal mortality rates of New Zealand and the UK and the Netherlands, all of which have state-sanctioned homebirth programs? Their perinatal mortality rates are not only comparable to or better than Australia’s but their intervention rates are better. Perinatal mortality rates in Australia are 10.1 per 10,000 live births. It is the same in New Zealand (despite their vastly smaller population which tends to skew statistics to look worse than they actually are). The UK’s perinatal mortality rate is 8 per 10,000 live births and the Netherlands 9 per 10,000 live births.

To support her point that all homebirthers care about are candles and home cooked meals, Connolly quotes various celebrities who have gushed over their homebirth experiences. But by pulling these quotes from the Homebirth Australia website she failed to do her homework and find out that Elle Macpherson birthed with the assistance of a private obstetrician in a birth centre. And where was the flippant quote from the great Australian thinker and journalist George Negus who’s wife Kristy was also a homebirther? Is Connolly seriously calling educated and philanthropic people like George and Kristy “selfish, irresponsible anti-reason and anti-progress?”

Another interesting nugget in Connolly’s rant is that she mistakenly believes that narcotics somehow make birth safer and that women who homebirth don’t have access to antibiotics, oxygen and oxytocic drugs. This is far from the truth. Most homebirthers are well aware of the need to obtain an oxygen tank, and oxytocic drugs from the local pharmacy prior to birth and organise this with their local GP (because midwives are prevented from prescribing these in Australia despite it being within their scope of practice). That said, most women who birth at home choose to avoid drugs and unnecessary antibiotics, not just because they want a beautiful birth experience but because they are informed and educated about the harm these can do to their babies. The fact is, we aren’t in a war torn country with no access to medical care when it is needed. Women who genuinely need antibiotics are referred by their midwife to a GP or to the hospital for treatment. But let’s not let the facts get in the way of a good homebirther-bashing.

That women have lost babies in childbirth is sad and tragic but we are not in a position to judge whether or not being at a hospital would have made any difference in any of these cases. We are also not in a position to judge whether being at home might have saved the woman who died from an amniotic fluid embolism or who’s baby’s throat was accidentally cut during surgical delivery. On mercifully rare occasions terrible things happen in childbirth in whatever environment a woman births in—be it home or hospital–but telling every woman that she should have no choice but to birth her baby in a hospital is not only irresponsible it is misogynistic and misguided.

Australia: Law et al, 2008 (AIHW)

New Zealand: NZHIS, 2006

UK: CEMACH, 2008 & NHS Information Centre 2008

Netherlands: Statline, 2008 (Statistical Yearbook 2004)

NB: It is important to note that different countries record perinatal statistics differently. The WHO standard is to report deaths from 22 weeks gestation. Most countries, however, seem to record rates from either 24 or 28 weeks. In order to present a more consistent picture, the 24 weeks has been used where possible.